Diabetes Health and Wellbeing Coach

Using Digital platforms like to support people to improve their health and wider wellbeing. Use of proactive approved analytic tools for smarter targeting of eligible patients. Working with the social prescriber, care coordinator and other services to connect them to community-based activities which support their health and wellbeing. Contemporaneous recording the data on RIO and use of templates and processes. Initiation of the jointly created personalized care plan and assisting care coordinators, social prescriber and or other community services staff in reviewing and meeting the personalized needs of the patients. Undertake if not already done by the care coordinator the first Patient Activation Measure (PAM) questionnaire to identify peoples levels of knowledge, skills and confidence (activation) and document. Undertake the second PAM review, reassess, and review the care plans accordingly. Work with people with lower activation to understand their level of knowledge, skills, and confidence (their Activation level) when engaging with their health and wellbeing. Asses, advice and encourage patients to jointly agree the action plan and ensure that it is achieved in timely fashion.